Birth in developing countries

The BBC has put together an amazing series of articles on birth and maternal mortality in developing countries. This year, at the half-way mark towards the Millenium Goals set for 2015, we’re not even close to reaching the desired 75% reduction in maternal mortality. These articles explore the reasons behind these failures: everything from lack of US funding for the United Nations Population fund (ostensibly because the UNFPA doesn’t outlaw abortion) to the low status of women in developing countries, the low priority given to women’s health issues, unsafe drinking water, lack of access to medical facilities and skilled birth attendants, infection, poor nutrition and low birth weight.

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Yes, yes, I agree. Similar to the first quote, on September 15th (on my blog) in reference to maternal mortality of black women I said:

“Maternal health disparities exist because we allow them to. We allow them to because the women who are dying are no longer valuable to us. History says if we still needed them to plow our fields, clean our houses, or feed our babies from their breasts, they would not be dying.

I went to a presentation about this exact topic. A doctoral candidate went to Bangladesh to study maternal mortality. It was an interesting topic because in Bangladesh, a patriarchal country, they had attempted to train the traditional birth attendants since most of the births there are at home. The plan in Bangladesh failed due in part to restrictions against women’s movement. In order for the midwives to work freely, there had to be escorts and supervision which greatly increased the cost of the program. Now, they’re looking at promoting birth in a health facility, rather than the midwife-centered care plan they tried earlier. As you can imagine, I’m perplexed at promoting hospital/facility birth over homebirth. What are your thoughts?

I am so struggling right now with everything midwifery. I can’t figure out what the hell I’m doing here. I understand why they want to make the shift to facility birth, it just sounds “easier.” To continue the midwifery practice of serving women in their homes they would have to change their fundamental beliefs about women, and that’s hard. No patriarchal society wants to lose it’s privilege by promoting the rights of women (including free movement)…why would they?…the way it is right now works to their benefit. Would the women who are coming to the clinic require escorts? If so, I’m wondering how facility birth would be more cost-effective??? Now, instead of one woman needing one escort to go to several houses…you need several workers to escort several women to one “house.” That’s more expensive…